scholarly journals Usage of and satisfaction with Integrated Community Case Management care in western Uganda: a cross-sectional survey

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
James S. Miller ◽  
Palka Patel ◽  
Sara Mian-McCarthy ◽  
Andrew Christopher Wesuta ◽  
Michael Matte ◽  
...  
Keyword(s):  
Case Management ◽  
Health Facility ◽  
Health Workers ◽  
Initial Assessment ◽  
Community Case Management ◽  
Cross Sectional Survey ◽  
Integrated Community Case Management ◽  
Cross Sectional ◽  
Western Uganda ◽  
Children Under 5

Abstract Background In some areas of Uganda, village health workers (VHW) deliver Integrated Community Case Management (iCCM) care, providing initial assessment of children under 5 years of age as well as protocol-based treatment of malaria, pneumonia, and diarrhoea for eligible patients. Little is known about community perspectives on or satisfaction with iCCM care. This study examines usage of and satisfaction with iCCM care as well as potential associations between these outcomes and time required to travel to the household’s preferred health facility. Methods A cross-sectional household survey was administered in a rural subcounty in western Uganda during December 2016, using a stratified random sampling approach in villages where iCCM care was available. Households were eligible if the household contained one or more children under 5 years of age. Results A total of 271 households across 8 villages were included in the final sample. Of these, 39% reported that it took over an hour to reach their preferred health facility, and 73% reported walking to the health facility; 92% stated they had seen a VHW for iCCM care in the past, and 55% had seen a VHW in the month prior to the survey. Of respondents whose households had sought iCCM care, 60% rated their overall experience as “very good” or “excellent,” 97% stated they would seek iCCM care in the future, and 92% stated they were “confident” or “very confident” in the VHW’s overall abilities. Longer travel time to the household’s preferred health facility did not appear to be associated with higher propensity to seek iCCM care or higher overall satisfaction with iCCM care. Conclusions In this setting, community usage of and satisfaction with iCCM care for malaria, pneumonia, and diarrhoea appears high overall. Ease of access to facility-based care did not appear to impact the choice to access iCCM care or satisfaction with iCCM care.

scholarly journals Baseline malaria prevalence and care-seeking behaviours in rural Madagascar prior to a trial to expand malaria community case management to all ages

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Dean Sayre ◽  
Laura C. Steinhardt ◽  
Judickaelle Irinantenaina ◽  
Catherine Dentinger ◽  
Tsinjo Fehizoro Rasoanaivo ◽  
...  
Keyword(s):  
Case Management ◽  
Cluster Randomized Trial ◽  
Malaria Prevalence ◽  
Care Seeking ◽  
Older Individuals ◽  
Community Case Management ◽  
Cross Sectional Survey ◽  
Integrated Community Case Management ◽  
Cross Sectional ◽  
Community Healthcare

Abstract Background Integrated community case management of malaria, pneumonia, and diarrhoea can reduce mortality in children under five years (CU5) in resource-poor countries. There is growing interest in expanding malaria community case management (mCCM) to older individuals, but limited empirical evidence exists to guide this expansion. As part of a two-year cluster-randomized trial of mCCM expansion to all ages in southeastern Madagascar, a cross-sectional survey was conducted to assess baseline malaria prevalence and healthcare-seeking behaviours. Methods Two enumeration areas (EAs) were randomly chosen from each catchment area of the 30 health facilities (HFs) in Farafangana district designated for the mCCM age expansion trial; 28 households were randomly selected from each EA for the survey. All household members were asked about recent illness and care-seeking, and malaria prevalence was assessed by rapid diagnostic test (RDT) among children < 15 years of age. Weighted population estimates and Rao-Scott chi-squared tests were used to examine illness, care-seeking, malaria case management, and malaria prevalence patterns. Results Illness in the two weeks prior to the survey was reported by 459 (6.7%) of 8050 respondents in 334 of 1458 households surveyed. Most individuals noting illness (375/459; 82.3%) reported fever. Of those reporting fever, 28.7% (112/375) sought care; this did not vary by participant age (p = 0.66). Most participants seeking care for fever visited public HFs (48/112, 46.8%), or community healthcare volunteers (CHVs) (40/112, 31.0%). Of those presenting with fever at HFs or to CHVs, 87.0% and 71.0%, respectively, reported being tested for malaria. RDT positivity among 3,316 tested children < 15 years was 25.4% (CI: 21.5–29.4%) and increased with age: 16.9% in CU5 versus 31.8% in 5–14-year-olds (p < 0.0001). Among RDT-positive individuals, 28.4% of CU5 and 18.5% of 5–14-year-olds reported fever in the two weeks prior to survey (p = 0.044). Conclusions The higher prevalence of malaria among older individuals coupled with high rates of malaria testing for those who sought care at CHVs suggest that expanding mCCM to older individuals may substantially increase the number of infected individuals with improved access to care, which could have additional favorable effects on malaria transmission.

scholarly journals Cost analysis of integrated community case management of childhood malaria, diarrhea and pneumonia enhanced by mobile health technology in rural Zambia

2020 ◽  
Vol 10 (2) ◽  
Author(s):  
Godfrey Biemba ◽  
Arnold Mulenga ◽  
Boniface Chiluba ◽  
Ulla K. Griffiths ◽  
Kojo Yeboah-Antwi ◽  
...  
Keyword(s):  
Supply Chain ◽  
Supply Chain Management ◽  
Case Management ◽  
Incremental Cost ◽  
Health Facility ◽  
Health Workers ◽  
Community Case Management ◽  
Integrated Community Case Management ◽  
Chain Management ◽  
Mhealth Intervention

Integrated community case management (iCCM) of malaria, diarrhea, and pneumonia is a comprehensive, equitybased strategy to improve treatment access for underserved children under five years old. This paper presents data on cost of iCCM and incremental costs of mHealth enhanced supervision and supply chain management in Zambia. We collected cost data using three questionnaires applied at national, district, health facility and community levels. We interviewed 40 health facility supervisors and 75 community health workers. A provider perspective and an ingredient costing method was used. We entered and analyzed data in a customized excel costing tool. The result shows that total iCCM cost per patient contact was USD 18.43. The incremental cost of using the mHealth intervention per child contact for all iCCM conditions was USD 11.35. The incremental cost per treatment of diarrhea, pneumonia, and malaria with mHealth intervention was USD 9.58, USD 10.37 and USD 12.82. Program costs accounted for 67% of the total, and the largest share was associated with supervision estimated at 36%, followed by supply chain management at 27%. This study has provided valuable information to policy makers on how much it costs to implement iCCM program using mHealth interventions.

Factors Influencing Choice of Delivery Place among Mothers in Rukungiri and Kanungu Districts, South Western Uganda: A Cross Sectional Study

2020 ◽  
Author(s):  
Richard Mugambe ◽  
Habib Yakubu ◽  
Solomon Wafula ◽  
Tonny Ssekamatte ◽  
Simon Kasasa ◽  
...  
Keyword(s):  
Health Facility ◽  
Rural Areas ◽  
Health Workers ◽  
Public Health Facility ◽  
Facility Delivery ◽  
Health Facilities ◽  
Public Facility ◽  
Cross Sectional ◽  
Western Uganda ◽  
Delivery Place

Abstract Background: Child birth in health facilities is generally associated with lower risk of maternal and neonatal mortality. However, in Uganda, little is known about factors that influence use of health facilities for delivery especially in rural areas. In this study, we examined the determinants of mothers’ decision of the choice of child delivery place in Western Uganda.Methods: Cross-sectional data was collected from 894 randomly-sampled mothers within the catchment of two private hospitals in Rukungiri and Kanungu districts. Data was collected on the place of delivery for the most recent child, mothers’ sociodemographic characteristics, health facility water, sanitation and hygiene (WASH) status. Modified Poisson regression was used to estimate prevalence ratios (PRs) for the determinants of mothers’ choice of delivery place as well as determinants for the choice of private versus public facility for delivery at 95% confidence intervals. Results: Majority of mothers (90.2%) delivered in health facilities. Non-facility deliveries were attributed to fast progression of labour (77.3%), lack of transport (31.8%) and high cost of hospital delivery (12.5%). Being engaged in business as an occupation [APR = 1.06, 95% CI (1.01 – 1.11)] and belonging to the highest wealth quintile [APR = 1.09, 95% CI (1.02 – 1.17)] favoured facility delivery while higher parity of 3 – 4 [APR = 0.93, 95% CI (0.88 – 0.99)] was inversely associated with facility delivery as compared to parity of 1-2. Choice of private facility over public facility was influenced by how mothers valued factors such as high skilled health workers [APR = 1.15, 95% CI (1.05 – 1.26)], higher quality of WASH services [APR = 1.11, 95% CI (1.04 – 1.17)], cost of the delivery [APR = 0.85, 95% CI (0.78 – 0.92)] and availability of caesarean services [APR = 1.13, 95% CI (1.08 – 1.19)].Conclusion: Utilization of health facility child delivery services was high. Health facility delivery service utilization was influenced by engaging in business, belonging to wealthiest quintile and being multiparous. Choice of private versus public health facility for child delivery was influenced by health facility WASH status, cost of services, and availability of skilled workforce and caesarean services.

scholarly journals Contribution of Community Health Workers to the treatment of common illnesses among under 5-year-olds in rural Uganda.

2021 ◽  
Author(s):  
Fred Bagenda ◽  
Andrew Christopher Wesuta ◽  
Geren Stone ◽  
Moses Ntaro ◽  
Palka Patel ◽  
...  
Keyword(s):  
Case Management ◽  
Community Health ◽  
Community Health Workers ◽  
Management Strategy ◽  
Health Workers ◽  
Community Case Management ◽  
Integrated Community Case Management ◽  
Children Under Five ◽  
Under Five ◽  
Common Illnesses

Abstract Introduction The control of malaria, pneumonia, and diarrhea is important for the reduction in morbidity and mortality among children under five years. Uganda has adopted the Integrated Community Case Management strategy using Community Health Workers to address this challenge. The extent and trend of these three conditions managed by the Community Health Workers are not well documented. This study was done to document Community Health Workers’ contribution towards treatment and the trends of the three common illnesses in Bugoye Sub-County in rural Uganda.

scholarly journals Willingness to Pay for Community Health Financing: An Approach to Financing and Sustainability of Integrated Community Case Management of Childhood Illness in Rural Communities in Niger State

2021 ◽  
pp. 82-92
Author(s):  
I. M. Sheshi ◽  
A. Ahmed ◽  
M. D. Sani ◽  
Y. F. Issa ◽  
B. E. Agbana
Keyword(s):  
Health Services ◽  
Case Management ◽  
Willingness To Pay ◽  
State Government ◽  
Community Intervention ◽  
Health Financing ◽  
Community Case Management ◽  
Integrated Community Case Management ◽  
Cross Sectional ◽  
The Government

Introduction: Community based health financing mechanism is referred to as a process whereby household in a community finance or co finance the recurrent and capital cost associated with a given set of health services thereby also include management of financial scheme and organization of health services. Iccm as a strategy to providing integrated case management services for two or more illness including diarrhea, malaria, pneumonia among children from two to upto five years. It is a community approach where lay persons are trained on management of the three diseases. This approach is being funded by foreign donor. However, there was stipulated period in which this support would elapsed and the support from the state Government may not be feasible. In an attempt to source for financing of iccm, this study aim at determining the willingness of the caregiver to use Community financing approach through payment of Premium to finance this community intervention (iccm). The concept of willingness to pay is maximum price a consumer is willing to pay for a given product or services. Materials and Methodology: A descriptive Cross sectional study was carried out among four hundred respondents that were selected using Multi stage sampling technique. Data was collected, coded and entered into a computer. Analysis was carried out using SPSS. Chi Square and logistic regression was used as a test of significance. Level of significance was set at Pvalue less than 0.05. Results: Twenty two percent of the respondents had good knowledge of iccm activities. Less than half of the respondents 41.3% were satisfied with iccm activities. Majority of the respondents 93.3% were willing to pay. Out of this, half of them 50.0% said they could only afford to pay less than 1000 naira per annum and 72.8% said the convenient time to pay was during the harvesting time. Factors influencing willingness to pay include Age, marital status and income level ( Pvalue <0.05). Knowledge and level of satisfaction were not influencing factors. The predictor of willingness to pay are aged 38-47 years and income of less than 5000 naira. Conclusion and Recommendation: There was willingness of the respondents to contribute for financing and sustainability of iccm in Niger State but the amount the majority of them were willing to pay was less than 1000 naira which might not able to sustain the iccm activities. There may be need for further research to determine amount needed for the annual activities and hence sustainability of iccm. The Government should show much responsibilities toward financing of iccm. Bi-apartite arrangement could be made between State Government and the Communities with iccm in place on how to share some responsibilities of iccm activities.

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